Cervical intraepithelial neoplasia recurrence after conization in HIV-positive and HIV-negative women

Objectives: To evaluate the recurrence rates of cervical intraepithelial neoplasia (CIN) in a cohort of HIV-infected and noninfected women who underwent the loop electrosurgical excision procedure (LEEP). Methods: A prospective cohort study of 94 HIV-positive and 107 HIV-negative women, both with CIN, treated with LEEP. The diagnosis of recurrence was established after biopsy. The Kaplan-Meier method was used for survival analysis and multivariate analyses were carried out using the Cox proportional hazards regression model. Results: There was a predominance of low-grade lesions in HIV-positive compared with HIV-negative women (P<0.01). Recurrence was more frequent with compromised margins and glandular involvement (P<0.01). A multivariate analysis showed that HIV-infection, glandular involvement, and positive margins were independently associated with recurrence of lesions. Conclusions: Recurrence rate of CIN in HIV-positive women was higher than in HIV-negative women. The factors associated with recurrence were HIV infection, glandular involvement, and positive margins. (C) 2008 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.